Most of the remaining chapters of this book contain guidelines to help you evalu- ate different aspects of a research report critically, focusing primarily on the methodologic decisions that the researcher made in conducting the study. Box 3.3 presents some further questions related to performing a preliminary overview of a research report, drawing on concepts explained in this chapter. These guidelines supplement those presented in Box 1.1, Chapter 1.
1. What is the study all about? What are the main phenomena, concepts, or constructs under investigation?
2. If the study is quantitative, what are the independent and dependent variables (if applicable)?
3. Did the researchers examine relationships or patterns of association among variables or concepts? Does the report imply the possibility of a causal relationship?
4. Are key concepts clearly defined, both conceptually and operationally?
5. What type of study does it appear to be, in terms of types described in this chapter—
experimental or nonexperimental/observational? grounded theory? phenomenology?
ethnography?
6. Does the report provide any information to suggest how long the study took to complete?
BOX 3.3 ADDITIONAL QUESTIONS FOR A PRELIMINARY REVIEW OF A STUDY
In this section, we illustrate the progression of activities and discuss the time schedule of two studies (one quantitative and the other qualitative) conducted by the second author of this book.
EXAMPLE 1 ■ Project Schedule for a Quantitative Study Study
Further validation of the Postpartum Depression Screening Scale (Beck & Gable, 2001).
R E S E A R C H E X A M P L E S A N D C R I T I C A L T H I N K I N G A C T I V I T I E S
Study Purpose
Beck and Gable undertook a study to assess the Postpartum Depression Screening Scale (PDSS), an instrument designed for use by clinicians and researchers to screen mothers for postpartum depression.
Study Methods
This study required nearly 3 years to complete. Key activities and methodologic decisions included the following:
Phase 1. Conceptual Phase: 1 Month. This phase was the shortest, in large part because much of the conceptual work had been done in Beck and Gable’s (2000) first study, in which they actually developed the screening scale. The literature had already been reviewed, so they only needed to update it. The same framework and conceptual definitions that had been used in the first study were used in the new study.
Phase 2. Design and Planning Phase: 6 Months. The second phase was time-consuming. It included not only fine-tuning the research design, but gaining entrée into the hospital from which subjects were recruited and obtaining approval from the hospital’s human subjects review committee. During this period, Beck met with statistical consultants and with Gable, an instrument development specialist, numerous times to finalize the study design.
Phase 3. Empirical Phase: 11 Months. Data collection took almost a year to complete. The design called for administering the PDSS to 150 mothers who were 6 weeks postpartum, and then scheduling them for a psychiatric diagnostic interview to determine if they were suffer- ing from postpartum depression. Women were recruited into the study during prepared child- birth classes. Recruitment began 4 months before data collection, and then the researchers had to wait until 6 weeks after delivery to gather data. The nurse psychotherapist, who had her own clinical practice, was able to come to the hospital only 1 day a week to conduct the diagnostic interviews; this contributed to the time required to achieve the desired sample size.
Phase 4. Analytic Phase: 3 Months. Statistical tests were performed to determine a cut-off score on the PDSS above which mothers would be identified as having screened positive for postpartum depression. Data analysis also was undertaken to determine the accuracy of the PDSS in predicting diagnosed postpartum depression. During this phase, Beck met with Gable and with statisticians to interpret results.
Phase 5. Dissemination Phase: 18 Months.The researchers prepared and submitted their report to the journal Nursing Researchfor possible publication. It was accepted within 4 months, but it was “in press” (awaiting publication) for 14 months before being published.
During this period, the authors presented their findings at regional and international confer- ences. The researchers also had to prepare a summary report for submission to the agency that funded the research.
CRITICAL THINKING SUGGESTIONS*:
*See the Student Resource CD-ROM for a discussion of these questions.
1. Answer the questions from Box 3-3 regarding this study.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in understanding this study:
a. What do you think is the population for this study?
b. Would you describe the method of data collection as self-reportor observation?
c. How would you evaluate Beck and Gable’s dissemintation plan?
d. Do you think an appropriate amount of time was allocated to the various phases and steps in this study?
e. Would it have been appropriate for the researchers to address the research question using qualitative research methods? Why or why not?
3. If the results of this study are valid and generalizable, what might be some of the uses to which the findings could be put in clinical practice?
EXAMPLE 2 ■ Project Schedule for a Qualitative Study Study
Birth trauma: In the eye of the beholder (Beck, 2004).
Study Purpose
The purpose of this study was to understand the experience of birth trauma from the mothers’ own perspectives.
Study Methods
The total time required to complete this study was nearly 3 years. Beck’s key activities included the following:
Phase 1. Conceptual Phase: 3 Months. Beck, who is renowned for her program of research on postpartum depression, became interested in birth trauma when she was invited to deliver the keynote address at the September 2001 Australasian Marce Society Biennial Scientific Meeting in New Zealand. She was asked to speak on perinatal anxiety disorders. In reviewing the literature to prepare the address, Beck located only a few published studies describing birth trauma and its resulting post-traumatic stress disorder (PTSD). Following her keynote speech, a mother made a riveting presentation about her experience of PTSD due to a
traumatic birth. The mother, Sue Watson, was one of the founders of Trauma and Birth Stress (TABS), a charitable trust in New Zealand. Before Watson had finished her presentation, Beck realized that she wanted to do research on birth trauma. Later that day, Watson and Beck dis- cussed the possibility of Beck conducting a qualitative study with the mothers who were members of TABS. Gaining entrée into TABS was facilitated by Watson who, with other founders of TABS, approved the study.
Phase 2. Design and Planning Phase: 3 Months. Beck selected a phenomenological design for this research. She corresponded by email with Watson to design an approach for recruiting mothers. Plans were made for Beck to write an introductory letter explaining the study, and for Watson to write a letter endorsing the study. Both letters would be sent to the mothers who were members of TABS, asking for their cooperation.
Once the basic design was finalized, Beck obtained approval by the human subjects committee at her university.
Phase 3. Empirical/Analytic Phases 24 months. Data for the study were collected over an 18-month period. During that period, 40 mothers sent their stories of birth trauma to Beck via e-mail attachments. For an additional 6 months Beck analyzed the mothers’ stories. Four themes emerged from data analysis: (1) To care for me: Was that too much to ask? (2) To communicate with me: Why was this neglected? (3) To provide safe care: You betrayed my trust and I felt powerless. and (4) The end justifies the means: At whose expense? At what price?
Phase 4 Dissemination Phase: 5+ Months. A manuscript describing this study was submit- ted to the journal Nursing Researchin April 2003. In June, Beck received a letter from the journal’s editor indicating that the reviewers’ of her manuscript recommended she revise and resubmit it. Six weeks later Beck resubmitted a revised manuscript that incorporated the reviewers’ recommendations. In September 2003 Beck received notification that her revised manuscript had been accepted for publication. The article was published in the January/Feb- ruary 2004 issue. Additionally, Beck has presented the findings at numerous national and international research conferences.
CRITICAL THINKING SUGGESTIONS:
1. Answer the questions from Box 3.3 regarding this study.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in understanding this study:
a. Given the study purpose, was a phenomenological approach appropriate for this study?
b. Do you think an appropriate amount of time was allocated to the various phases and steps in this study?
c. How would you evaluate Beck dissemination plan?
d. Would it have been appropriate for Beck to address the research question using quanti- tative research methods? Why or why not?
EXAMPLE 3 ■ Quantitative Research in Appendix A
1. Read the abstract and the introduction from Howell and colleagues’ (2007) study (“Anxiety, anger, and blood pressure in children”) in Appendix A of this book, and then answer the relevant questions in Box 3.3.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in assessing aspects of the study’s merit:
a. Could any of the variables in this study be considered constructs?
b. Did this report present any actual data from the study participants?
c. Would it have been possible for the researchers to use an experimental design for this study?
EXAMPLE 4 ■ Qualitative Research in Appendix B
1. Read the abstract and introduction from Beck’s (2006) study (“Anniversary of birth trauma”) in Appendix B of this book and then answer the relevant questions in Box 3.3.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in assessing aspects of the study’s merit:
a. Find an example of actual data in this study (You will need to look at the “Results” sec- tion of this study).
b. How long did it take Beck to collect the data for this study? (You will find this informa- tion in the “Procedure” section.)
c. How much time elapsed between when the paper was accepted for publication and when it was actually published? (You will find relevant information at the end of the paper).
CHAPTER REVIEW
Key new terms introduced in the chapter, together with a summary of major points, are presented in this section. Chapter 3 of the accompanying Study Guide for Essen- tials of Nursing Research,7th edition also offers exercises and study suggestions for reinforcing the concepts presented in this chapter. For additional review, see self- study questions on the CD-ROM provided with this book.
Key New Terms
Cause-and-effect (causal) relationship
Clinical trial Concept
Conceptual definition Construct
Data
Dependent variable Emergent design Ethnography
Experimental research Fieldwork
Gaining entrée Grounded theory Hypothesis
Independent variable Intervention protocol Literature review Nonexperimental
research
Observational research Operational definition Outcome variable Phenomenology
Population Qualitative data Quantitative data Relationship Research design Sample
Sampling plan Saturation
Statistical analysis Study participant Subject
Variable
Summary Points
* The people who provide information to the researchers (investigators) in a studyare referred to as subjects, study participants,or respondentsin quan- titative research, or study participants or informants in qualitative research;
collectively they comprise the sample.
* The siteis the overall location for the research; researchers sometimes engage in multisite studies. Settingsare the more specific places where data collection will occur. Settings for nursing research can range from totally naturalistic envi- ronments to formal laboratories.
* Researchers investigate concepts and phenomena (or constructs), which are abstractions or mental representations inferred from behavior or characteristics.
* Concepts are the building blocks of theories,which are systematic explanations of some aspect of the real world.
* In quantitative studies, concepts are called variables. A variableis a character- istic or quality that takes on different values (i.e., varies from one person or object to another).
* The dependent (or outcome) variable is the behavior, characteristic, or out- come the researcher is interested in understanding, explaining, predicting, or
affecting. The independent variableis the presumed cause of, antecedent to, or influence on the dependent variable.
* A conceptual definitiondescribes the abstract or theoretical meaning of the concepts being studied. An operational definition specifies the procedures required to measure a variable.
* Data—the information collected during the course of a study—may take the form of narrative information (qualitative data) or numeric values (quantitative data).
* A relationship is a bond or connection (or pattern of association) between two variables. Quantitative researchers examine the relationship between the inde- pendent variables and dependent variables.
* When the independent variable causes or affects the dependent variable, the relationship is a cause-and-effect (causal) relationship. In a functional or associative relationship, variables are related in a noncausal way.
* A basic distinction in quantitative studies is between experimental research, in which researchers actively intervene, and nonexperimental (or observational) research,in which researchers make observations of existing phenomena with- out intervening.
* Qualitative research often is rooted in research traditions that originate in other disciplines. Three such traditions are grounded theory, phenomenology, and ethnography.
* Grounded theory seeks to describe and understand key social psychological and structural processes that occur in a social setting.
* Phenomenology focuses on the lived experiences of humans and is an approach to gaining insight into what the life experiences of people are like and what they mean.
* Ethnographyprovides a framework for studying the meanings, patterns, and lifeways of a culture in a holistic fashion.
* In a quantitative study, researchers usually progress in a linear fashion from ask- ing research questions to answering them. The main phases in a quantitative study are the conceptual, planning, empirical, analytic, and dissemination phases.
* The conceptual phaseinvolves (1) defining the problem to be studied; (2) doing a literature review; (3) engaging in clinical fieldwork for clinical studies;
(4) developing a framework and conceptual definitions; and (5) formulating hypothesesto be tested.
* The planning phaseentails (6) selecting a research design;(7) developing inter- vention protocolsif the study is experimental; (8) specifying the population;(9) developing a sampling plan;(10) specifying methods to measure the research vari- ables; (11) developing strategies to safeguard the rights of subjects; and (12) final- izing the research plan (e.g., conferring with colleagues, pretestinginstruments).
* The empirical phase involves (13) collecting data; and (14) preparing data for analysis (e.g., coding data).
* The analytic phaseinvolves (15) analyzing data through statistical analysis;and (16) interpreting the results.
* The dissemination phase entails (17) communicating the findings; and (18) efforts to promote the use of the study evidence in nursing practice.
* The flow of activities in a qualitative study is more flexible and less linear. Quali- tative studies typically involve an emergent design that evolves during fieldwork.
* Qualitative researchers begin with a broad question regarding a phenomenon of interest, often focusing on a little-studied aspect. In the early phase of a quali- tative study, researchers select a site and seek to gain entréeinto it, which typ- ically involves enlisting the cooperation of gatekeeperswithin the site.
* Once in the field, researchers select informants, collect data, and then analyze and interpret them in an iterative fashion; field experiences help in an ongoing fashion to shape the design of the study.
* Early analysis in qualitative research leads to refinements in sampling and data collection, until saturation (redundancy of information) is achieved. Analysis typically involves a search for critical themes.
* Both qualitative and quantitative researchers disseminate their findings, most often by publishing their research reports in professional journals.